Summary

Nutrition and Obesity: Assessment, Management and Prevention is a necessary, timely, and comprehensive text that provides an up-to-date, scientifically accurate study of our current understanding of the causes, consequences, and potential of individual and public responses to the serious health issue of obesity. It presents major concepts about obesity including new knowledge gained from recent advances in research on health risks, energy balance, eating behaviors, the biology of hunger and satiety, and pharmacotherapy and surgery as treatments for obesity. Additionally, the text sets obesity in a public health context that includes local, national, and international environmental policy approaches to assessment and prevention.

Table of Contents

Preface

p. xi

About the Authors

p. xv

Acknowledgments

p. xvii

Epidemiology, Assessment, Causes, and Risks Associated with Presence of Overweight and Obesity

p. 1

Current Obesity Trends

p. 3

Obesity Prevalence in the United States

p. 4

Obesity Definition

p. 4

How Obesity Data Are Collected

p. 6

Trends in Obesity: Increasing or Levelling Off?

p. 6

Extreme Obesity

p. 7

Childhood Obesity

p. 7

Disparities According to Sex and Ethnicity

p. 8

Effects of Socioeconomic Status

p. 10

Global Trends

p. 10

Summary

p. 11

Assessment of Body Weight and Body Composition

p. 15

Anthropometric Assessment of Optimal Body Weight

p. 16

Height-Weight Tables

p. 16

Calculating Ideal Body Weight

p. 16

Comprehensive and Consistent Assessment of Overweight and Obesity Recommended by National Institutes of Health (NIH)

p. 17

How is BMI Useful?

p. 18

Calculating BMI

p. 18

BMI Categories

p. 19

BMI Variation According to Ethnicity

p. 19

BMI Limitations

p. 21

Assessment of Body Composition and Fat Distribution

p. 22

Air and Water Displacement Techniques

p. 22

Dual Energy X-ray Absorptiometry (DEXA)

p. 23

Bioelectrical Impedance Analysis (BIA)

p. 24

Skinfold Measurement

p. 25

What Is a Normal Body Fat Percentage?

p. 25

Is Waist Circumference Measurement Better at Assessing Risk Than BMI?

p. 25

Presence of Other Risk Factors or Disease Comorbidities

p. 27

Methods to Assess Childhood and Adolescent Overweight and Obesity

p. 29

Summary

p. 29

Causes of Obesity

p. 33

Factors That Contribute to Obesity

p. 34

Energy Balance

p. 34

Metabolic Rate

p. 35

Energy Expenditure Terminology, Measurement, and Equations

p. 37

Equations for Calculation of BMR

p. 38

Thermic Effect of Food

p. 38

Energy Used During Physical Activity

p. 39

Environmental Contributors to Increased Energy Intake

p. 39

Food Availability

p. 40

Beverages Add More Calories

p. 40

Increased Portion Sizes

p. 41

Eating Away from Home

p. 41

Impact of Socioeconomic Status

p. 42

Reduced Opportunity for Physical Activity

p. 42

Metabolic and Genetic Contributions to Eating Behavior

p. 42

Homeostatic Controls

p. 42

Hendonic Systems

p. 44

Genetic Contributions to Obesity

p. 44

Summary

p. 45

Health and Economic Consequences of Obesity

p. 51

Health and Economic Consequences of Obesity

p. 52

Characteristics of Obesity Comorbidities

p. 52

An Increase in Frequency and Severity of the Disease Occurs When Adiposity Is Present

p. 52

An Improvement or Resolution of the Disease Occurs with Weight Loss

p. 52

A Plausible Explanation Exists for the Association of Obesity with the Disease State

p. 52

Obesity and Metabolic Syndrome

p. 53

Nonalcoholic Fatty Liver Disease

p. 54

Polycystic Ovary Syndrome

p. 55

Type 2 Diabetes

p. 55

Cardiovascular Disease

p. 56

Respiratory Disease

p. 58

Obstructive Sleep Apnea

p. 58

Asthma

p. 58

Malignancies

p. 58

Musculoskeletal Disorders

p. 58

Longevity

p. 59

Controversies About Obesity and Longevity

p. 59

Psychosocial Correlates of Obesity

p. 59

Quality of Life

p. 59

Discrimination and Bias

p. 60

Psychological Implications

p. 61

Economic Costs of Obesity

p. 61

Summary

p. 62

Strategies and Research for Weight Management and Obesity Prevention

p. 67

Dietary Interventions for Obesity Prevention and Management

p. 69

Energy Requirements for Weight Management

p. 70

Dietary Recommendations for Weights Management

p. 71

Food Groups and Energy Density

p. 72

Fruits and Vegetables Food Group

p. 72

Grains Food Group

p. 72

Dairy Food Group

p. 73

Protein Food Group

p. 73

Solid Fats and Added Sugars

p. 73

Alcoholic Beverages

p. 75

Portion Control

p. 75

Food Labels

p. 77

Timing of Meals

p. 78

Specific Diet Plans

p. 78

Calorie-Reduced Diets

p. 78

Recommended Macronutrient Distribution

p. 78

Low-Fat, High-Carbohydrate, High-Fiber Diets

p. 79

High-Protein, Low-Carbohydrate Diets

p. 79

Medically Supervised Very-Low-Calorie Diets

p. 79

Research Comparison of Diets

p. 80

Popular Diet Plans

p. 80

How Do We Know What Works?

p. 82

Summary

p. 83

Physical Activity

p. 87

Energy Balance and Physical Activity

p. 88

Definitions of Physical Activity

p. 88

Trends in Physical Activity

p. 89

How Physical Activity Data Are Collected

p. 90

Recommendations for Physical Activity

p. 93

Physical Activity for Good Health, Fitness, and Prevention of Obesity

p. 93

Physical Activity Recommendations for Children and Youth

p. 94

Physical Activity for Weight Loss

p. 94

Physical Activity to Prevent Weight Regain

p. 95

Physical Activity and the National Weight Control Registry Participants

p. 96

Benefits, Risks, and Costs of Physical Activity

p. 97

Metabolic Health

p. 97

Risks

p. 98

Costs

p. 99

Summary

p. 99

Pharmacologic Agents in Obesity Management

p. 103

Medications for Weight Loss

p. 104

Incidence: How Many People Use Weight-Loss Medications?

p. 104

How Are Prescription Weight-Loss Medications Regulated?

p. 105

Pharmacological Mechanisms of Prescription Weight-Loss Medications

p. 105

Products That Work Systematically as Appetite Suppressants

p. 105

Products That Inhibit Absorption of Fat from the Gastrointestinal Tract